ABSTRACT
Objetivo: Describir los resultados obtenidos de la experiencia en el tratamiento con acetato de abiraterona (AA) en 25 hombres con cáncer de próstata metastásico resistente a la castración (CPMRC). Realizamos el análisis comparativo de la eficacia y seguridad de este fármaco en relación con la literatura existente. Material y método: Estudio biinstitucional prospectivo de una cohorte de 25 pacientes consecutivos que reciben tratamiento con AA por CPMRC, con un seguimiento medio 7,9 (3-15) meses. Análisis de la seguridad y eficacia del tratamiento en relación con las características basales de los pacientes (edad, tratamientos previos, PSA basal, performance status, dolor, metástasis). Resultados: La supervivencia global es del 80% a los 13,6 meses de seguimiento (IC 95%: 11,8-15,4). La supervivencia libre de progresión clínico-radiológica de la serie es de 9,5 ± 1 meses (IC 95%: 7,7-11,3) y el de respuesta bioquímica de 6,8 ± 1 meses (IC 95%: 5-8,7). Solo el tratamiento previo con quimioterapia empeora significativamente el tiempo de respuesta a AA (supervivencia libre de progresión radiológica 6,4 meses [IC 95%: 4,2-8,6] y bioquímica de 4,3 meses [IC 95%: 2,6-6]). La incidencia de efectos adversos fue del 36%, todos grado 1-2/4, y en ningún caso requiere suspender o disminuir la dosis de AA. Conclusiones: El tratamiento con AA ha sido eficaz en nuestra serie, con una tolerabilidad considerablemente mayor a lo publicado en otros estudios
Objective: To describe the results obtained in 25 men with metastatic castration-resistant prostate cancer (MCRPC) treated with abiraterone (AA). A comparative analysis of abiraterone effectiveness and safety between our results and data published in the literature was conducted. Materials and method: Bi-institutional prospective analysis of 25 consecutive patients with MCRPC undergoing treatment with abiraterone, with a mean follow-up 7.9 (3-15) months was carried out. Treatment effectiveness and safety analyses regarding baseline characteristics of patients (age, prior treatments, basal PSA, performance status, pain, and metastasis) were conducted. Results: At 13.6 months of follow-up, the overall survival is 80% (CI 95%: 11.8-15.4). Clinical and radiological-free progression survival is 9.5 ± 1 months (CI 95%: 7.7-11.3) and biochemical response is 6.8 ± 1 months (CI 95%: 5-8.7). Only the treatment with chemotherapy impaired significantly the response time to AA [6.4 months for radiological-free progression survival (CI 95%: 4.2-8.6) and 4.3 months for biochemical-free progression survival (CI 95%: 2.6-6)]. The incidence of adverse drug events was 36%; all of them were of grade 1-2/4 and, in no case, suspension or reduction of the dose of AA was needed. Conclusions: The treatment with AA has been effective in our series, with a tolerability considerably higher than what other studies published
Subject(s)
Humans , Male , Prostatic Neoplasms/drug therapy , Androgen Antagonists/therapeutic use , Hormone Replacement Therapy , Castration , Steroid 17-alpha-Hydroxylase/therapeutic useABSTRACT
OBJECTIVE: To describe the results obtained in 25 males with metastatic castration-resistant prostate cancer (MCRPC) treated with abiraterone (AA). A comparative analysis of abiraterone effectiveness and safety between our results and data published in the literature was conducted. MATERIAL AND METHOD: Bi-institutional prospective analysis of 25 consecutive patients with MCRPC undergoing treatment with abiraterone, with a mean follow-up 7.9 (3-15) months was carried out. Treatment effectiveness and safety analyses regarding baseline characteristics of patients (age, prior treatments, basal PSA, performance status, pain, metastasis) were conducted. RESULTS: At 13.6 months of follow-up, the overall survival is 80% (CI 95%: 11.8-15.4). Clinical and radiological-free progression survival is 9.5 ± 1 months (CI 95%: 7.7-11.3) and biochemical response is 6.8 ± 1 months (CI 95%: 5-8.7). Only the treatment with chemotherapy impaired significantly the response time to AA [6.4 months for radiological-free progression survival (CI 95%: 4.2-8,6) and 4.3 months for biochemical-free progression survival (CI 95%: 2.6-6)]. The incidence of adverse drug events was 36%, all of them grade 1-2/4 and, in no case, suspension or reduction of the dose of AA was needed. CONCLUSIONS: The treatment with AA has been effective in our series, with a tolerability considerably higher than what other studies published.
Subject(s)
Abiraterone Acetate/therapeutic use , Antineoplastic Agents/therapeutic use , Prostatic Neoplasms, Castration-Resistant/drug therapy , Aged , Aged, 80 and over , Disease-Free Survival , Humans , Male , Middle Aged , Prospective StudiesABSTRACT
BACKGROUND: The frecuency of malignancies in renal transplant (RT) patients is increasing. Renal cell carcinoma (RCC) of native kidneys is one of the most frequent and its outcome can be more aggressive than in general population. OBJECTIVE: To evaluate the incidence and prognosis of RCC in renal transplant patients followed in our transplantation unit. METHODS: Between January 1997 and December 2009, 683 patients underwent kidney transplant at our hospital. Ultrasonography of the native kidneys was annually performed in all renal transplant patients. When suspect solid masses were found at ultrasonography, patients underwent computed tomography. If the suspicion was confirmed, nephrectomy was performed. RESULTS: 14 radical nephrectomies were performed in 12 patients due to suspect CCR. In 11 nephrectomies (corresponding to 9 patients), anatomopathologic diagnosis was CCR (incidence 1.5%). Histologic stage was T1N0M0 in all cases. In the other 3 RT, the diagnosis was complicated renal cyst. Those patients without carcinoma had polycystic kidney disease. The time on dialysis before CCR diagnosis was 36.7 ± 24.3 months and the interval between RT and diagnosis was 39 ± 25.8 months. After a mean follow-up of 58.6 ± 38.6 months, the outcome of all cases has been excellent, without tumor recurrence. CONCLUSIONS: Annual renal ultrasonography plays a key role in the early diagnosis of CRR. The early treatment of this pathology is associated with an excellent prognosis in RT patients.
Subject(s)
Carcinoma, Renal Cell/diagnosis , Kidney Neoplasms/diagnosis , Kidney Transplantation , Postoperative Complications/diagnosis , Adult , Aged , Carcinoma, Renal Cell/diagnostic imaging , Carcinoma, Renal Cell/epidemiology , Carcinoma, Renal Cell/surgery , Early Diagnosis , False Positive Reactions , Female , Follow-Up Studies , Humans , Immunocompromised Host , Immunosuppressive Agents/adverse effects , Incidence , Kidney Neoplasms/diagnostic imaging , Kidney Neoplasms/epidemiology , Kidney Neoplasms/surgery , Male , Middle Aged , Nephrectomy , Polycystic Kidney Diseases/epidemiology , Polycystic Kidney Diseases/etiology , Polycystic Kidney, Autosomal Recessive/complications , Postoperative Complications/epidemiology , Postoperative Complications/surgery , Survival Rate , UltrasonographyABSTRACT
Cystic lesions at the midline of the prostate are uncommon and they are considered as congenital disorders. Is generally accepted that active treatment should be instituted only in symptomatic patients and watchful waiting in asymptomatic ones. The most common active treatment is minimally invasive surgery by puncture-aspiration or endoscopic unroofing. We are attaching an inmunosupressed patient because of a renal transplantation in which we provided an active treatment by puncture-aspiration of the cystic lesion in spite of being asymptomatic.
Subject(s)
Cysts/etiology , Kidney Transplantation/adverse effects , Prostatic Diseases/etiology , Adult , Humans , MaleABSTRACT
Las lesiones quísticas localizadas en la línea media de la próstata son poco frecuentes y se consideran alteraciones congénitas. Se acepta generalmente que el tratamiento activo se realiza sólo a los pacientes sintomáticos, haciendo observación a los asintomáticos. El tratamiento activo más común es la cirugía mínimamente invasiva por medio de punción-aspiración o la decorticación endoscópica. Aportamos un caso de un paciente inmunosuprimido por un trasplante renal, circunstancia que nos hizo optar por el tratamiento activo con punción aspiración del mismo, a pesar de ser asintomático
Cystic lesions at the midline of the prostate are uncommon and they are considered as congenital disorders. Is generally accepted that active treatment should be instituted only in symptomatic patients and watchful waiting in asymptomatic ones. The most common active treatment is minimally invasive surgery by puncture-aspiration or endoscopic unroofing. We are attaching an inmunosupressed patient because of a renal transplantation in which we provided an active treatment by puncture-aspiration of the cystic lesion in spite of being asymptomatic
Subject(s)
Male , Adult , Humans , Kidney Transplantation/pathology , Kidney Transplantation , Minimally Invasive Surgical Procedures/methods , Biopsy, Needle/methods , Endoscopy/methods , Prostatectomy/methods , Prostatic Neoplasms/complications , Prostatic Neoplasms/surgery , Prostate/pathology , Prostate/surgery , Minimally Invasive Surgical Procedures/trends , Minimally Invasive Surgical Procedures , Immunosuppression Therapy/methods , ProstateABSTRACT
OBJECTIVE: To report a rare case of renoureteral colic in a patient with a solitary left kidney, due to fibrosis around the renal pelvis and ureter from metastatic lobular carcinoma of the breast. METHODS/RESULTS: A 45-year-old patient consulted at the emergency services for pain in the left renal fossa that irradiated to the genital organs. Patient evaluation showed lid edema and oliguria. An abdominal ultrasound scan demonstrated left hydronephrosis. The cause of the obstruction could not be determined by imaging techniques. Exploratory lumbotomy was performed and the pelvis and ureter were released from the fibrotic covering. The histological analysis showed infiltration of the ureteral adventitia arising from lobular breast carcinoma. CONCLUSIONS: Retroperitoneal metastases that cause ureteral obstruction usually occur two years following diagnosis of the primary tumor. This is one of the few cases of ureteral obstruction from metastatic lobular carcinoma of the breast reported in the literature. Unlike the other cases, however, our patient showed a complicated genitourinary malformation.
